基于多模态影像学分析PCNS-DLBCL的临床表现及对预后的预测效能OACSTPCD

Objective:To investigate the multimodal imaging presentation of primary central nervous system diffuse large B-cell lymphoma(PCNS-DLBCL)and to analyze the predictive efficacy of the multimodal imaging presentation on prognosis.Methods:78 patients with PCNS-DLBCL admitted to our hospital from August 2020 to December 2022 were selected and the results of multimodal imaging were statistically analyzed.Standard CHOP regimen or Rituximab combined with standard CHOP regimen(R-CHOP)were used as first-line treatment.All patients underwent fluorodeoxyglucose positron emission computed tomography(18F-FDG PET/CT)before chemotherapy to obtain the total lesion glycolysis(TLG),metabolic tumor volume(MTV),SUVpeak,SUVmax and other parameters.According to the prognosis results,the patients were divided into non-progression group and progressive group,survival group and death group.The imaging parameters between non-progression group and progressive group,survival group and death group were compared,and the predictive value of each parameter on disease progression and death prognosis of PCNS-DLBCL patients was analyzed.Results:A total of 192 lesions were detected in 78 patients with PCNS-DLBCL by multimodal imaging,33 cases were single lesions(33 lesions)and 45 cases were multiple lesions(159 lesions).There was no significant difference in age,sex,lesion distribution,CT plain scan,MRI T1WI,MRI T2WI,MRI enhanced scan,FLAIR sequence,MRS,DWI,FDG PET/CT imaging findings between the single lesion group and the multiple lesion group(P＞0.05).The proportion of fist grip and fissure features in the single group was higher than that in the multiple group(P＜0.05).At 1 year follow-up,TLG,MTV,SUVpeak and SUVmax were lower than the progression group according to the progression and survival groups(P＜0.05).TLG,MTV,SUVpeak and SUVmax in the non-advanced group were lower than those in the advanced group(P＜0.05).TLG,MTV,SUVpeak and SUVmax in survival group were lower than those in death group(P＜0.05).The AUC of 18F-FDG PET/CT combined prediction of disease progression and death in PCNS-DLBCL patients was 0.901 and 0.930,respectively,which was greater than the AUC predicted by each parameter alone.Conclusion:There was no significant difference in the imaging findings of PCNS-DLBCL in single and multiple lesions.The 18F-FDG PET/CT parameters of patients with different disease progression and survival conditions were significantly different.TLG,MTV,SUVpeak and SUVmax have high predictive value for disease progression and death in PCNS-DLBCL patients.